Article: Is ADHD Properly Diagnosed & Treated in Adults

[~lostgurl~]

Is Attention-Deficit Hyperactivity Disorder Properly Diagnosed and Treated in Adults?

3 Jan 2007
The Royal College of Psychiatrists: Press Release

An editorial in the January 2007 issue of the British Journal of Psychiatry strongly recommends that general adult psychiatrists should diagnose and treat attention-deficit hyperactivity disorder (ADHD) in adults appropriately with stimulant drugs.

ADHD is a common disorder affecting children and adults, and is a predictor of adult mental health problems.

Symptoms include high levels of inattentiveness, impulsiveness and restless overactivity, and are regarded as a source of disability in children and adolescents, as well as a risk to adult psychological adjustment.

Although ADHD can be effectively treated with stimulant medication, and such treatment is widespread in the young, general adult psychiatry has not yet followed suit in identifying and treating substantial numbers of affected people.

Young people are entering adult life whilst still receiving medication for ADHD, and adult psychiatrists are needed to take over treatment when symptoms persist. Moreover, some adult patients with ADHD may be misdiagnosed and ineffectively treated for other disorders, such as depression and personality disorder.

Research suggests that between 15% and 65% of children diagnosed with ADHD still have symptoms of the disorder in adulthood. However, many children with ADHD go unrecognised, and may be diagnosed in adulthood for the first time.

A survey of schoolchildren with ADHD in the London Borough of Newham found that although levels of restless activity diminished between the ages of 7 and 17, the 17-year-olds showed a level of hyperactivity similar to that found in a group of normal 7-year-olds.

When the same people were followed up at the age of 26, they were found to have disabilities associated with high levels of psychiatric disorder, which were all the more significant because of increasing demands in adult life for self-organisation and the ability to plan ahead.

Adult behaviours linked to ADHD are associated with the childhood symptoms of motor hyperactivity, attention deficit, unfocused thinking, mood changes, disorganisation and impulsiveness.

They include – at the severe end of the spectrum - feelings of restlessness, difficulty in relaxing, feeling depressed when inactive, lack of concentration on detail, depression or excitability, poor time management, difficulties sustaining relationships and a tendency to make rapid and facile decisions without full analysis of the situation.

Psychiatrists diagnosing ADHD in adults need to be aware of the fact that people with this disorder often show decreased symptoms in a novel situation like a psychiatric evaluation. It is therefore important to base mental state evaluations on a typical week and a variety of normal situations.

Mood instability is very common in adult ADHD, and can lead to diagnoses of depression or personality disorder. Many adults with ADHD also have other problems, such as antisocial personality, alcohol and drug misuse, anxiety disorders and learning difficulties. ADHD in childhood may also lead to the development of antisocial behaviour.

Some symptoms of adult ADHD are similar to those of bipolar disorder, but ADHD tends to show a persisting trait of irritability and volatility, very different from the grandiose and euphoric symptoms of mania and the depression found in bipolar disorder.

Adults with untreated ADHD use more healthcare resources because of smoking-related disorders, increased rates of serious accidents, and alcohol and drug misuse. Further research is needed to quantify the contribution of ADHD to psychiatric disorders in adulthood.


References: Asherson P, Chen W, Craddock B and Taylor B (2007) Adult attention-deficit hyperactivity disorder: recognition and treatment in general adult psychiatry. British Journal of Psychiatry, 198, 4-5.


http://www.rcpsych.ac.uk/pressparlia...006/pr868.aspx

Reputation Comments on this post:

Good find.